Therapy in Action "With Insights and Strategies for Anyone Living or Working With Troubled Kids"

By C.S. Belle

Author Clarissa Star Crystal-Belle, LMHC, takes on the toughest, neediest kids and families in her role as a therapist for troubled children. In this fascinating glimpse into real-life case studies, Crystal-Belle seeks to “awaken the reader to a new way of looking at this population and a more effective way to address their needs.”

Crystal-Belle challenges the misuse of specific medications and behavior management techniques. She questions the practices of sentencing troubled kids to indefinite terms in special education. And in calling out those who use corporal punishment and shame-blame tactics, she introduces alternatives that include a team approach, embracing and engaging rather than condemning and alienating troubled kids.

If you’re living or working with kids who could test the patience of a saint; if you’re a parent or teacher or case worker at a loss to correct or redirect a defiant child; if you’re a professional who is seeking a new avenue in your counseling or medical approach—this book is for you.

• Language: English
• Publisher: Brighton Publishing LLC
• Release date: Jun 17, 2015
• ISBN: 9781621833277

C.S. Belle

Clarissa Star Crystal-Belle is the Co-Founder and Clinical Director of two Counseling Centers in Florida; the Star Point Counseling Center and the Affordable Counseling Center of Florida, located in Tampa, and Brandon. She is a qualified supervisor overseeing all services provided by Interns and she provides counseling services to Individuals, couples and families. She earned a Bachelor of Science Degree in Psychology with Honors of Distinction at the Johnson State College of Vermont, and a Master of Arts Degree in Clinical Psychology at the Vermont College of Norwich University. She holds an active license to practice Mental Health Counseling in the state of Florida and she is a member of the American Mental Health Counselors Association.When I am not providing counseling services, I enjoy catching up with my three daughters and sons in law, and my four granddaughters and two grandsons. I also enjoy writing, reading non-fiction as well as poetry and arm chair mysteries, walking along the beach, swimming in the pool, cooking, playing chess, and even pool on occasion although I get three turns to my opponents every one if I am to have any chance of winning.I strive to achieve and maintain a balanced lifestyle that includes spiritual mindfulness, personal growth and care, fostering strong family ties and keeping myself in good company, promoting the health and happiness of others in my practice, and keeping myself active in ways that are healthy, interesting, fulfilling and fun.

Book preview

Therapy in Action

With Insights and Strategies for Anyone Living or Working

With

Troubled Kids

C. S. Belle ~ LMHC

Brighton Publishing LLC

435 N. Harris Drive

Mesa, AZ 85203

www.BrightonPublishing.com

ISBN13: 978-1-62183-327-7

Copyright © 2015

eBook

SMASHWORDS EDITION

Cover Design: Tom Rodriguez

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage retrieval system, without permission in writing from the copyright owner.

Disclaimer

Names and identifying details have been changed to protect the privacy of individuals. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. I have tried to recreate events and conversations from my memories of them. In order to maintain their anonymity I have changed the names of individuals and places. I have changed some identifying characteristics and details such as physical properties, occupations, places of residence, and assigned the substance of conversations to different speakers. This book is not intended as a substitute for the advice of physicians, psychiatrists, educators, or mental health professionals. The reader should regularly consult a physician, psychiatrist, or mental health professional in matters relating to his/her mental health and particularly with respect to any symptoms that may require a medical or mental health diagnosis or medical attention. The information in this book is meant to supplement, not replace, proper training in mental health counseling, parenting, and classroom management. The author and publisher advise readers to take full responsibility for their actions and interactions and know their limits. Before practicing the skills described in this book, be sure that you are well informed, and do not take on tasks or individuals beyond your level of experience, aptitude, training, and comfort level.

Dedication

I dedicate this book, first and foremost, to my three daughters, Jennifer, Kelsea and Alicia. Your love, many years of sacrifice, and encouragement has given me the inspiration and time, I needed to provide all those years of service to other families and to finally bring this book to completion.

I also want to dedicate my book, in part, to my best friend and business partner, Sam, and my dear friend, Carol, for believing in me whenever I expressed any doubts about whether or not I could ever complete the editing process.

Introduction

A troubled child is like a single pebble that sends ripples across a still lake, disturbing all that lies within its spheres. There is no escape. Whether your eyes are closed or your body is numb, the ripples will move you all the same. They come in the form of unwanted influences on you and your own children, in your child’s school and in your community. They come in the form of crime, untreated mental illness, substance abuse, and in immoral and unethical practices imposed on children by caregivers and professionals assigned to their care. They come in an ever-increasing population of professionals and caregivers who cannot identify their own shortcomings and who lack the skills to effectively manage troubled kids.

This book is a window through which you will be able to see the psychodynamics and environmental factors that contribute to that ripple effect. You will also discover within yourself all that it takes to make a difference in the lives of those with whom you interact, on both a personal and professional level, every day.

I have worked with acting-out children for over thirty years in family homes, on school grounds, in classrooms, in the screening area of crisis stabilization units, or wherever my sessions took me. These are the settings where I have learned the enabling and destructive dynamics of relationships that trouble troubled kids. I teach and demonstrate, by example, how to empower troubled kids and the adults in their lives, to heal, learn, and grow.

I challenge those who deal with troubled kids to look beyond the obvious and to refrain from snap judgments. I check reactive interventions and ineffective traditional decrees and practices. I expose and redirect reactive responses that erupt from unexamined biases and personal prejudices. I encourage a team approach that embraces and engages rather than condemns and alienates troubled kids and their caregivers. I describe and then work to create an environment inside the home and classroom that opens its arms to troubled kids who have learned to feel alienated or to feel that they have nowhere safe to turn for understanding and refuge.

I challenge the misuse of specific medications and behavior management techniques. I question the practices of sentencing troubled kids to indefinite terms in special education classes. I also challenge the use of corporal punishment and the shame and blame tactics often used to modify the acting-out behaviors of troubled kids.

In the chapters that follow, I have presented families of varying economic advantage. My experience has taught me that the most damaging type of poverty is to be found, not in the economic aspect of the home, but in the felt impoverishment of spiritual awareness in some of the most religious homes, and in the absence of expressed genuine regard and affection in some of the most affluent homes.

I invite the reader to follow me into the classrooms, homes, and other arenas where my observations, assessments, interventions, and didactic discussions have taken place. I invite you to challenge yourself to keep an open mind and to consider a new approach to interpreting the nature of, and then intervening in the outcome of, the challenges troubled kids face.

I hope to awaken those who employ ineffective practices to a new way of looking at troubled kids and a new and more effective way to address their needs by demonstrating how teaching and therapy go hand in hand. I demonstrate how to root out the information needed to prevent mislabeling. I challenge trends that lead to misdiagnoses and ineffective treatments of troubled kids. I advise guardians and professionals to team up with the psychiatrist, psychologist, or therapist in their own community, as well as with the clients and the adults in the lives of troubled children, and to keep an open, inquiring mind. In order to learn the best approaches we must know the questions that need to be answered.

Parents have come to me whose child has been on medication for five to eight years for ADHD, with multiple referrals at school, placement in special education, increased oppositional defiance, and decreased governability at home. In many cases excessive punishments and consequences have been enforced and privileges taken away, one by one, until there are no privileges left to remove. And yet, the child’s behavior has escalated further until the whole family is out of control.

Perhaps the proper diagnosis isn’t ADHD. Perhaps the symptoms only mirror ADHD and are masking a more accurate diagnosis. I ask questions in a way that leads to a disclosure of historical and current traumatic events or levels of stress that the child or adult has suffered or is suffering that have never before been disclosed.

I have had similar experiences in the schools. I have to say to the teachers, If the behavior management techniques aren’t working, perhaps we aren’t identifying the actual problem. Perhaps we are identifying the symptoms and trying to get rid of them without identifying and getting rid of the underlying cause.

. In our efforts to be original with our behavioral and cognitive treatment approaches, we minimize the affective impact of historical life experiences. We fail to recognize the affective roots of a child’s current mental and emotional state and how those are reflected in their behavior.

We have grown calloused in our response to the way children feel; yet we demand that they behave. We are masking the problem by treating the symptoms that way.

Some professionals and guardians inadvertently escalate troubled children in their efforts to de-escalate them. The focus needs to then shift from the child to the adults in the child’s life. We need to educate them on how to implement the self-control and environmental controls that will help to de-escalate the troubled child.

I developed an instrument I call the Telling Wheel (described in Chapter Two). It is used for identifying the people who influence the lives of troubled children. I discovered that many adults in the life of a troubled child lacked the knowledge they needed to improve their lives and the lives of the child in their care. I did not step back from that lack of knowledge with an arrogant air; instead, I embraced it. We have to give adults and children more credit for being able to learn.

I discovered that many of the people influencing troubled children suffered from depression or substance dependence—or a combination of the two. Those and other mental and personality disorders can severely compromise their ability to maintain a healthy environment for the development of the children in their care. I speak to this as well and demonstrate ways to empower that population to seek and benefit from counseling services in their local community.

When confronted with children, adolescents, and adults who demonstrate that they have little hope for a healthy and productive life, I have to ask, What phases of their development are they stuck in, and why? Are they presenting the emotional age of a three- to five-year-old? If so, perhaps something happened at that stage that harnessed them to that level of emotional development. It could be something as wonderful as the birth of a sibling or something as shattering as the death of a parent or a divorce. There could have been an isolated incident of abuse or a sequence of abusive incidents in that child’s past.

Freud taught that the affect that occurred at the time of a deeply disturbing or traumatic event is sustained in the personality and consciousness of the person for as long as the memory of the event is repressed. Once the content of that event or events is recalled and exposed, we can identify how much of the affect that we see now is carried over from the response to that historical event. We can then validate it. What I mean by that is that we can stop minimizing the affect of the person. We can stop condemning or diminishing the person for being outraged, mortified, or in excruciating pain, and instead reach out and comfort the person right at the source of that pain. Not only is the comforting long overdue, but it is the hook that engages the whole person in the process of treatment.

Once we have hooked the person, we can begin to demonstrate and teach that such a degree of despair or fear is no longer warranted by current or present circumstances. Until that happens, a minor inconvenience can be seen as a catastrophe. A minor itch or irritation can be felt as a lightning bolt. A look of preoccupation can be seen as loathing or indifference. A scolding or even the facial expressions of disapproval can be felt as a death threat.

When I explain to guardians and teachers how repressed phenomena are reflected in current behavior, the response is one of reflection and then, shock. I see that shift in their eyes. What follows is an uninvited self-awareness and deep remorse for the way they had responded up to that moment. I also see a deep sense of relief in response to the realization that they are not the sole cause of how the child is behaving. I use that instance of vulnerability to say, When I see that a patient or his caregiver is demonstrating such a degree of despair, pain, or fear, I stop, step back, sit down, and contemplate an individualized course of action. The action I choose will focus on healing how the person feels, and then on the behaviors that need to change.

The cliché that people don’t change baffles me. When you help a person change the way he or she feels, they want to behave better. We are mistaken to think that they enjoy negative consequences. We make another mistake: expecting them to change their behavior automatically. They can’t because certain behaviors that were felt at one time to be essential to their existence have become as involuntary as breathing.

Children want to please and, for the life of them, cannot explain why or how they could do the thing again that they had resolved to never do. When they say they are sorry, they really mean it. This is a truth troubled children have proven to me time and again. Once released from the affect of trauma, the troubled child then has to identify and deliberately break the patterns or habits of behavior that they acquired during the traumatic period. Such behaviors were at one time felt to be necessary for their mental, emotional, or physical survival. When we attempt to change or charge them to change those protective behaviors without removing the affect that brought them about, we are perceived by the child to be threatening his or her very survival. No wonder we have such a battle on our hands. Behavior management and cognitive therapies alone do not work for them. Even the medications they’re on will either have no effect or worsen the situation.

I have introduced the reasoning behind my interventions through discussions that empower rather than enable or condemn that population. I presume on the receptivity and intelligence of my readers now, just as I presumed on the intelligence of my patients and clients over the years. I am using the word intelligence to describe not just the wealth of knowledge they possess but also their capacity to learn. The receptivity of my patients and clients was there for the most part, owing to the fact that their way was not working. They were asking for help.

It is true that not everyone demonstrates a capacity to learn. No amount of education will make its way through deaf ears. No stone will absorb nurturing. There are vast populations of us who are deaf to the best counsel. There are also those of us who are too numb, too guilt ridden, or too hurt or angry to feel another’s pain or rage. While it may be that they could, one day, benefit from an intervention, they won’t benefit from it now, no matter what you do. But there is a way to approach that inspires them to seek help, sooner or later. They may not seek the help from you, but down the road all you have said and done will begin to ring true in real-life situations. They often come up with ideas as if they were their own—ideas you imparted days, months, even years ago. Positive interventions, whether immediately successful or not, are never wasted on the suffering.

My intent is to reach out to more families and professionals through this book. I have been very successful in awakening individuals to new and more effective responses to troubled kids in my face-to-face contacts. I hope to achieve the same result, here and now, with my readers.

Chapter One

Billy, Amy Lynn, and Kevin

I’ve often wondered, Whatever happened to Billy, Amy Lynn, and Kevin? Billy and Amy Lynn’s cases were presented on the last day before I resigned from my position at a community-based mental health agency. Kevin’s second visit to that same agency had been on my last day there as well. Did they receive the care and counseling services they needed? Or, like so many other little ones, did they slip through the cracks of our child protective system for too long?

If they didn’t get the help they needed, in time, then it is likely that, by the time any intervention was offered, they wouldn’t be spared a lifetime of reactive thought and behavior patterns that compromised their ability to learn, to function in any meaningful way, to secure gainful employment, or to have even a smidgeon of a notion of what a healthy, loving, and satisfying relationship might be like for them.

So many children coming from similar circumstances slip through our fingers or hide behind their fears so well that we don’t discover them until they are grown and struggling out in the world on their own. Many more come within our spheres but trigger such defensive reactions in us that we miss the opportunity to hear the secrets they hold. By missing those opportunities, one by one, we inadvertently place so many bricks in the wall between us and them that we—guardians, teachers, and other professionals—can’t even begin to see, hear, or understand what is troubling them.

I begin with snapshots of the three of them because they represent countless children suffering similar circumstances for no good reason. They live just beyond our reach and scope of vision, right now, somewhere, not too far from where we live. Their stories, as they were told that day, inspired me to write this book. They aroused in me a deep sense of responsibility to expose the injustices they and so many others endure.

***

Little Billy is five years old. His father is an alcoholic and his mother is on crack. His sister walks the avenue to pay for Daddy’s beer. She pays for Mommy’s drugs, too, and the shirt on Billy’s back.

Billy got in trouble for fighting in school today, after another little boy tried to grab a French fry from his lunch tray. His teacher didn’t know that lunch was the first and only meal Billy would receive that day. All she knew was what she saw, and what she saw was Billy pushing the other little boy so hard that he almost fell backwards off the bench. It took her less than a minute to pull him out of the lunch room and down to the principal’s office, where he was ordered to sit on his hands and to be still, while she called his father to come pick him up.

Even more unfortunate for Billy was that his father had been drinking all night and was passed out when the call came in from the school. His teacher had to call three times before he answered the phone. When he did, he wasn’t happy to hear that, because of Billy’s behavior, he was going to have to get up, get dressed, and drive all the way to Billy’s school while hung over. Daddy was so angry by the time they got home that he picked Billy up and threw him against the wall. Billy lost consciousness and had to be rushed to the hospital. Now his father is in jail and his mother says, It’s Billy’s fault!

***

Amy Lynn is thirteen years old. Her parents are the owners of a very successful business. She lives with her family in a seemingly secure and extremely affluent neighborhood where everyone enjoys the luxuries of an exceptionally high-end lifestyle. And yet, despite all the material comforts of her home, she is miserable. She was suspended from school for being belligerent and defiant with her teacher after getting caught sleeping in class. Having been warned several times that day to sit up straight and pay attention, she lashed out with a stream of defensive speech because her teacher had scolded her in front of everyone.

In response to Amy Lynn’s defensive speech and inappropriate word choices, her teacher proclaimed that Amy Lynn had been warned enough. As her teacher left the room to call Amy Lynn’s mother, she called back over her shoulder, Today is the last straw!

To Amy Lynn’s mother the teacher said, If she keeps refusing to pay attention, she shouldn’t be here at all.

How was her teacher to know that Amy Lynn slept in class because her father kept her up at night? Her teacher couldn’t possibly know because Daddy tells her, over and over again, that if she tells anyone about what he’s doing, Mommy will make him punish her for lying. He scared her into silence and secrecy, saying, Who would they believe, anyway—the successful businessman, or some silly girl who obviously couldn’t care less about getting an education?

No, there was no way for Amy Lynn’s teacher to know. Night after night, Amy Lynn cried after her father left her room. She did care about getting an education. She wanted the other kids to stop laughing at her. She ached to have friends. She wanted to be able to giggle, chat, and carry on as if she too hadn’t a care in the world, like all the other girls. These thoughts ran through her mind every night as she lay in bed, sobbing on her pillow.

When Amy Lynn was suspended from school, her mother told her father to take a belt to her. He told Amy Lynn he was sorry he had to do this, but she didn’t believe him. She made up her mind she wouldn’t cry this time, so when he ordered her to go to his room and to lie across his bed, she obeyed, determined not to make so much as wince. Instead, she clutched the blanket and held her breath while he belted her again and again.

In response to her deliberate silence, he hollered, You’re enjoying this! She still wouldn’t respond, so he whispered, If you don’t cry, your mother will get suspicious. Please don’t make me do this.

She dug her nails even deeper into the bed and remained silent. He got so exasperated that he threw his belt down on the floor and told her to get out of there. She got up and slowly left the room, hoping that by the time her three days of suspension were up, no one would see the welts.

As she walked to the stairs that led up to her room, which was at the end of what now seemed a very long hall, she saw her mother standing at the top of the stairs. She was peering down, as if she were listening, waiting, and searching Amy Lynn’s face for tears. Not wanting to give her mother the satisfaction of seeing her cry, Amy Lynn deliberately fixed her eyes on her bedroom door at the end of the hall. As she passed her mother, she half expected her to lash out with a slap to her face or a tug on her hair. Instead, her mother screamed at her.

You can just stay in there and serve out your three days of suspension! You’ll never amount to anything—girls like you are a dime a dozen!

***

Kevin, aged nine, was taken to the Intake Department of the Crises Stabilization Unit (CSU) in the middle of the night, by a Child Protective Services (CPS) investigator. I was working there part-time as an evaluation for admission screener.

After reporting that Kevin’s father had tried to strangle him, the investigator said he wanted me to admit Kevin into the CSU so that he wouldn’t have to disturb a foster home at that late hour. It was immediately clear, however, that Kevin didn’t want to be there. From the minute he was brought in, he threw a terrible temper tantrum. He kicked the door, threw himself on the floor, and kicked and knocked over two of the chairs. He cried, screamed, and pleaded with everyone in the room to please take him back home right now!

To protect him from hurting himself or anyone else, the staff technicians threatened to put him in seclusion in four-point restraints. They told Kevin they could restrain him using cuffs on his arms and legs that are fastened to straps on the bed. One of the technicians said he wouldn’t be able to move and asked how he would like that.

I objected and suggested to Kevin that he slip into my office, instead, where he could tell me why he needed to go home. The idea calmed him down. In my office I asked him to tell me what had happened to him.

He told me his mother and father had gotten into a fight. When he tried to break them up, his father grabbed him by the throat, slammed him up against the wall, and said he’d kill him if he didn’t get the hell out of there. Kevin said he ran to his grandpa’s home, two blocks down the road, and called 911. It was 3:00 a.m., but he hadn’t stopped to think how dark and scary it was out there.

The father had left the home by the time the police arrived. They called CPS despite his mother’s denial that the fight had involved any of her children after a report was made about what Kevin had alleged the father did to him. He was then taken from the home until they could complete the investigation.

I let Kevin know how sorry I felt for what he had gone through. I reached my hand out and gently felt the area where I could see the finger burns around his neck. He must have been scared for his life when he ran out of the house in the middle of the night. I wanted him to know that he was safe now with us. But no matter what I said, he wouldn’t be consoled. He kept repeating that he had to go home. He begged and pleaded for me to tell them to take him home.

I gave him some paper and a box of crayons and told him I would go out and see what I could do about the situation. I tried to make him feel better by giving him at least a ray of hope that I would do something, if I could. I was puzzled, though. Why did he want to go back there when his father had nearly strangled him and threatened to kill him? Why wasn’t he relieved now that he was safe?

As soon as I returned to my office, I got my answer as he explained the figures in his drawing. His mother was drawn bent over on the floor. His baby sister was upside down on the couch. His sister, aged seven, was drawn hiding under a bed. I understood in that instant why he was being so willful and defiant. He wasn’t thinking of himself at all—he was afraid for them. He truly believed that his father could kill the whole family if he got angry enough. He was scared for his sisters. He had to get back there so he could protect and watch out for them.

I flashed back to the reaction of the staff and thought to myself, And for this he could have been put in seclusion and four-point restraints.

You don’t understand! he stammered, insisting that his sisters needed him. Nobody understands! And then he began to cry enormous sobs. He kept repeating, No one will be there to take care of them. If they cry he’ll hurt them. They don’t cry when their brother is there. He pounded his nine-year-old chest with his thumb and cried, I’m the only one that can keep them quiet.

I told him I would ask the investigator again if he would go back to take his sisters out of the home.

When I got back to the waiting room, I approached the investigator, showed him the drawing, and asked that he go back and check on Kevin’s sisters. He said, No. He then qualified his stance, saying, The report said nothing about the girls.

Well, he is saying something now, I argued. He’s afraid for them. That is what all the commotion was about. He’s scared their father will hurt them. That is why he feels he needs to get back there, right now.

I can only go by what is in the report, ma’am.

But Kevin thinks his father will be back, and when he does return, there’s a good chance the fight will start up again. Why don’t you go in and talk to him?

Seeing he was unmoved, I continued, He’ll tell you enough to warrant going back to get the rest of them. There are finger burns on his neck that are more prominent now than when he first came in.

The investigator shrugged, rolled his eyes, and then said, I’ll take a look at the marks and put it in my report, but as far as it goes for the rest of them, I can’t go by what he thinks is going to happen. He shrugged and rolled his eyes again, holding both of his hands out, palms up, as if to say there was nothing he could do about it. But then he said, Look, we have twenty-four hours to file a report on cases like this. I’ll go by there in the morning after I take care of him.

I was able to tell Kevin that the investigator would go back and check on his siblings for him. I thanked Kevin for trying to protect his sisters and told him they were lucky to have him for a brother. I then began the paperwork I needed to complete in order to admit him on the unit for the night. He did seem to meet the criteria for an involuntary admission when he first arrived. We weren’t a quick stop for children en route to foster homes. But Kevin had been through so much that night. I wanted to keep him for observation even though he had settled down.

The investigator picked him up later that morning, and Kevin was placed in a local foster home so he wouldn’t have to change schools.

A couple of weeks later, two law enforcement officers returned him to us in handcuffs. Kevin had threatened to kill himself during an altercation with his teacher, and he had acted out until she finally threatened to have him evaluated for special education. She told him his mother should ask his doctor for Ritalin or something to calm him down. He had been unmanageable in the foster placement, too, because of the way he felt about being separated from his mother and siblings when he was taken out of the home. He felt punished by our efforts to protect him.

I was relieved to learn later that Kevin was referred to our home-and school-based intervention program, once he was deemed stable enough to be released from the Crisis Stabilization Unit.

***

Troubled children such as Billy, Amy Lynn, and Kevin haven’t made the news. They aren’t lost causes yet. They haven’t murdered anyone or sold their parent’s furniture for drugs. They haven’t vandalized the schools or robbed anyone on the bus. They haven’t stolen anybody’s car for a joy ride around the block.

Children who have committed such offenses are regarded as trouble with a capital T and often end up in Juvenile Justice Intervention programs. But children such as Billy, Amy Lynn, and Kevin are living among us, suffering right under our noses, in our schools and neighborhoods. If they are lucky enough, they are referred into family home intervention programs.

I used to have both types on my caseload. I used to say, The delinquent kids are the kids we missed in our home intervention program.

Troubled children live in high-risk environments where they are subjected to verbal, emotional, and physical violence. They experience turmoil, neglect, and chaos, almost daily.

Some people regard the kids that are trouble and the troubled ones all the same. They think the kids targeted for home intervention belong in the delinquent category, because that is where they are obviously headed anyway. But while they don’t belong with delinquents, they don’t fit in with the more fortunate or normal kids either. They are different and require more